© 2003 Fellowship of Postgraduate Medicine
CASE REPORT
Multiple brain abscesses in a patient with bilateral pulmonary arteriovenous malformations and immunoglobulin deficiency
1 Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
2 Department of Radiology
3 Department of Clinical Microbiology
4 Department of Neurosurgery
Correspondence to:
Correspondence to:
Dr Kenneth W Tsang
Department of Medicine, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China; kwttsang{at}hku.hk
A 34 year old Chinese man presented with grand mal seizures complicating multiple brain abscesses caused by mixed oral flora. Because of persistent hypoxaemia contrast spiral thoracic computed tomography was done, which revealed bilateral pulmonary arteriovenous malformations (PAVMs). Concomitant IgA and IgG subclass deficiency was also found. The combination of these two conditions appears to have predisposed this patient to presumably paradoxical septic embolism. The patients cerebral condition responded to postoperative antibiotic treatment and he eventually received selective coil embolisation of right lower lobe PAVMs, which relieved his hypoxaemia and dyspnoea.
Keywords: brain abscess; pulmonary arteriovenous malformation; immunoglobulin deficiency
Abbreviations: MRA, magnetic resonance angiography; PAVM, pulmonary arteriovenous malformation
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